Provider Demographics
NPI:1437264009
Name:NORTHAMPTON PHYSICIANS INC
Entity Type:Organization
Organization Name:NORTHAMPTON PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOREN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:POOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-666-7716
Mailing Address - Street 1:2293 IRA ROAD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-1903
Mailing Address - Country:US
Mailing Address - Phone:330-666-7716
Mailing Address - Fax:330-666-1080
Practice Address - Street 1:4557 QUICK RD
Practice Address - Street 2:
Practice Address - City:PENINSULA
Practice Address - State:OH
Practice Address - Zip Code:44264-9794
Practice Address - Country:US
Practice Address - Phone:330-923-7828
Practice Address - Fax:330-923-1201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0612680Medicaid
OH0612680Medicaid